Organization
SOUTHEAST MISSOURI HEALTH NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS JONES (CHIEF EXECUTIVE OFFICER)
(573) 313-2500
Entity
Organization
Contact information
Practice address
6738 STATE HIGHWAY 77, BENTON, MO 63736-8238
(573) 313-2500
(573) 313-2505
Mailing address
6738 STATE HIGHWAY 77, BENTON, MO 63736-8238
(573) 313-2500
(573) 313-2505
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
400704003
—
MO
05
—
406087205
—
MO
05
—
406126003
—
MO
05
—
500704010
—
MO
05
—
500704028
—
MO
05
—
500704036
—
MO
05
—
500704051
—
MO
05
—
503973901
—
MO
Enumeration date
07/20/2005
Last updated
10/21/2020
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